OBJECTIVES:  Given the burden of asthma, it is important that robust cost-effectiveness analyses are undertaken to inform decision making. This research reports the results from a structured literature review of cost-effectiveness models in asthma to inform the development of a new cost-effectiveness model in asthma. METHODS: A structured review of published literature was conducted in Embase, Medline, EconLIT and Evidence-Based Medicine Reviews using the OVID search engine. Searches were limited to full-text English publications (January 2004–May 2016). Additional searches were conducted in the conference proceedings of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and published Health Technology Assessment (HTA) submissions (January 2004–May 2016). RESULTS:  A total of 31 publications reporting cost-effectiveness models for asthma were identified. Active comparators included: combination therapy of high-dose inhaled glucocorticosteroids and long-acting β2-agonists (n=17), add-on therapy tiotropium (n=4), an antileukotriene (n=1) and biologic omalizumab (n=9) in the treatment of asthma. The cost-effectiveness models identified in the review were largely Markov models (MMs) (n=26). Of these, three were country adaptations of the same model, and the design of the remaining five were unspecified. The majority utilised three health states; controlled, partially controlled and uncontrolled as defined by the Global Initiative for Asthma (GINA/GEMA) (n=8) or non-exacerbation, exacerbation or exacerbation with hospitalisation as defined by the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN) (n=3). The models were developed to inform decision making in: Italy, Spain, US, Columbia, Netherlands, UK, Canada, Japan, Republic of Belarus, Russia, Belgian, Mexico, Australia, Poland, Portugal, Greece and Brazil. None of the models reviewed appeared to capture the health and cost impact of inhaler handling errors. CONCLUSIONS:  There are a number of cost-effectiveness models developed in the area of asthma. Despite some common features identified, there is no clear consensus on the best approach to fully capture the clinical and economic impact of asthma.